Powell Medical LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

POWELL MEDICAL LLC

Practice address

107 N Greenfield Rd Ste 1
Mesa, AZ 85205-7802

Phone

(480) 741-8041

NPI assigned

May 24, 2023

Last updated

Dec 29, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Matthew Reed Powell, MDNPI 1194110965

Title

Owner

Phone

(480) 741-8041

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Reed Powell, MD

  • Family Medicine Physician
  • Mesa, AZ
  • NPI 1194110965
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1467144758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N GREENFIELD RD STE 1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852057802",
            "telephone_number": "480-741-8041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N GREENFIELD RD STE 1",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852057802",
            "telephone_number": "480-741-8041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWELL MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "REED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-741-8041",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Kaye Pourbastani, ANP-BC
• Sam Pourian, DC
• Faith A Pourkaveh
• Anjeanette Pout
• Daren Todd Povar, DPT
• Allisynn Marie Powell, OTR/L
• Arthur Frederick Powell, NMD
• Audrey Powell
• Jackie Powell, MAC, LISAC
• Matthew Reed Powell, MD

• Family Medicine Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.